title: Evaluating an holistic assessment tool for palliative care practice.
abstract: OBJECTIVE
  To evaluate a holistic assessment tool for palliative care practice. This included identifying patients' needs using the holistic tool and exploring the usability, applicability and barriers and facilitators towards implementation in practice.
  
  
  BACKGROUND
  The delivery of effective holistic palliative care requires a careful assessment of the patients' needs and circumstances. Whilst holistic assessment of palliative care needs is advocated, questions exist around the appropriateness of tools to assist this process.
  
  
  METHODS
  Mixed-method research design.
  
  
  METHODS
  Data collection involved an analysis of piloted holistic assessments undertaken using the tool (n = 132) and two focus groups with healthcare professionals (n = 10).
  
  
  RESULTS
  The tool enabled health professionals to identify and gain an understanding of the needs of the patients, specifically in relation to the physical healthcare needs. Differences, however, between the analysis of the tool documentation and focus group responses were identified in particular areas. For example, 59 (68·8%) respondents had discussed preferred priorities of care with the patient; however, focus group comments revealed participants had concerns around this. Similarly, whilst over half of responses (n = 50; 57·5%) had considered a prognostic clinical indicator for the patient as an action, focus group results indicated questions around healthcare professionals' knowledge and perceived usefulness of such indicators. Positive aspects of the tool were that it was easy to understand and captured the needs of individuals. Negative aspects of the tool were that it was repetitive and the experience of assessors required consideration.
  
  
  CONCLUSIONS
  The tool evaluation identified questions regarding holistic assessment in palliative care practice and the importance of communication.
  
  
  CONCLUSIONS
  A holistic assessment tool can support patient assessment and identification of patients' needs in the 'real world' of palliative care practice, but the 'tool' is merely an aid to assist professionals to discuss difficult and sensitive aspects of care.
authors.affiliation: Institute of Nursing Research, University of Ulster/All Ireland Institute of Hospice and Palliative Care, Northern Ireland, UK.
authors.forename: Sonja
authors.initials: S
authors.lastname: McIlfatrick
authors.forename: Felicity
authors.initials: F
authors.lastname: Hasson
mesh_terms: D017144:Focus Groups; D006694:Holistic Health; D010166:Palliative Care; D010865:Pilot Projects
keywords: assessment; evaluation research; holistic care; mixed methods; palliative care